Tehran University Medical Journal

Background: Anemia is the most common nutritional disorder in the world in which iron deficiency is one of its main causes. The prevalence of obesity and risk of iron deficiency anemia in these individuals is increasing. The present study examined the association between iron deficiency, dietary intake and obesity and obesity-induced inflammation in female students.
Methods: This descriptive cross-sectional study was conducted in Ahvaz University of Medical Sciences, Ahvaz, Iran, from May to March of 2016. A total of 170 female students were selected by stratified random sampling. Being in the age of 18-35 years, having a regular menstrual cycle, not following a specific diet and not taking any medication or dietary supplements that could affect iron status were indicators of inclusion in the study. General information and physical activity questionnaire were completed and a semi-quantitative feed frequency questionnaire was used to obtain food intake information. Anthropometric indicators including weight, height, body mass index (BMI), waist circumference and body fat were measured. Obesity was evaluated with 3 different definitions. Biochemical indices such as iron, hemoglobin, hematocrit, transferrin, total iron binding capacity (TIBC), ferritin, and hs-CRP were also measured.
Results: The dietary intake of iron and some nutrients related to iron (including energy, protein, vitamin C and calcium) showed no significant difference in dietary intake between different groups of obesity definitions. Serum iron levels and hemoglobin concentration had a significant negative correlation with BMI and hs-CRP concentrations (P=0.026 and P=0.01 respectively). The relationship between transferrin levels and total iron binding capacity with the index of waist circumference was positive and significant (P=0.040, P=0.034, respectively). Also, there was a significant positive correlation between obesity and hs-CRP levels (P=0.014). There was no significant relationship between other evaluated factors with different degrees of obesity.
Conclusion: Chronic obesity and inflammation which could be caused by obesity, can contribute to iron deficiency, regardless of dietary iron intake.

Background: Developmental and behavioral disorders are the most prevalent problems in children after infection and trauma. Growth and development are influenced by genetic, social and environmental factors that incept of the early life of the fetal and neonatal periods. Due to the importance of the development in children, this study was conducted to determine the relationship between growth indices at birth and developmental status in infancy.
Methods: This case-control study investigated 6 to 18 months old infants, who referred to comprehensive health centers affiliated to Qazvin University of Medical Sciences, Iran, from August to December 2017. The sample size in this study was 200 infants and the participants were evaluated in two groups of 100 subjects (developmental delay and normal development). Anthropometric indices at birth were collected from healthcare records, and developmental status was measured using the ages and stages questionnaire (ASQ). The developmental status of the children was measured in five domains, i.e., motor (gross and fine motor skills), problem-solving, personal-social skills and communication. A significance level was considered statistically <0.05.
Results: The mean age of the infants in the developmental delay group was 12.63±1.72 months and the mean age of the infants in control group was 12.68±1.69 months and 45.6% of children in the developmental delay group were female and 54.4% of children in the developmental delay group were male. The most prevalence developmental delay in case group was in the area of personal-social domain (26.9%) and the lowest prevalence developmental delay in the area of the gross motor (12.7%). No correlation was found between head circumference (P= 0.32) and height at birth (P= 0.11) and developmental status. However, there was a significant relationship between developmental delay in the area of the communication (P= 0.04) and gross motor (P= 0.02) with birth weight. Pearson correlation indicate a correlation between developmental delay in the area of the gross motor and birth weight (P= 0.01).
Conclusion: It seems that birth weight was a factor that is associated with developmental delay. In this study low birth weight correlated with developmental delay in communication and gross motor aspects of ASQ.

Background: Children's health, preserving and promoting it is a health priority of any society. Malnutrition affects all age groups, but malnutrition in children is one of the most common nutritional problems that can delay body growth, shortened height, frequent infections, mental retardation, the prevalence of mental disorders, lack of academic achievement and reduced efficacy. Because of the importance and impact of this issue in children, the purpose of this study was a systematic review and meta-analysis of the prevalence of underweight in Iranian children, in order to highlight the importance of this issue to health policy-makers.
Methods: A meta-analysis was performed for relevant articles in scientific databases including Scientific Information Database (SID), ScienceDirect, PubMed and Google Scholar. Entrance criteria included cross-sectional studies (March 1996 to February 2017) that had a low incidence of underweight in Iranian children in different parts of Iran. Non-relevant articles included review articles, interventions, cohorts and case studies, and studies that looked at obesity, overweight and the relationship between these factors and other diseases, excluded from the study list. Reference lists of identified articles were reviewed for additional articles. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Begg and Mazumdar's rank correlation test and a significance level of 0.1. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: In 26 articles reviewed in the study, total number of participants was 142938  persons at the age of 1 month to 12 years. The overall prevalence of underweight in Iranian children was 15.5% (Cl 95%: 12%-19.7%) during 1996 to 2017. The highest prevalence of underweight in was recorded in Birjand city in 2006 and Zahedan city in 2009, 68.6% (Cl 95%: 63.3%-72.9%) and the lowest prevalence of underweight in was found in city of Jahrom in 2013, 1.8% (Cl 95%: 1.2%-2.9%).
Conclusion: According to the results of this study, the prevalence of low-birth-weight in the country is high and requires interventional measures.

Background: Trying to find a drug with more clinical efficacy in treating obesity is one of the priorities. The aim of this study was to evaluate the efficacy of orlistat, sibutramine, lorcaserin and metformin on weight loss in obese people.
Methods: The databases of PubMed, Scopus, Google Scholar and Cochran Library were searched up to November 2016. In present study search strategy was performed by using selected keywords. Two independent investigators scanned and extracted the relevant data. The pairwise method was used to compare the difference between the mean difference weight loss for orlistat, sibutramine, lorcaserin and metformin in two direct methods (comparison of orlistat, sibutramine, lorcaserin and metformin with the control group) and non-direct (Compare orlistat, sibutramine, lorcaserin and metformin together). We assessed the quality of included trials using the quantitative 5-point Jadad scale. The heterogeneity across studies was assessed by using Cochrane’s Q and I2 tests. Publication bias was reported by means of funnel plots and Egger’s tests. 
Results: The present study performed on 36 clinical studies with a population of 3672. Our study results did show that sibutramine (mean difference -4.97 kg, 95% confidence interval -6.70 to -3.23), metformin (mean difference -4.45 kg, 95% confidence interval -9.27 to 0.38), orlistat (mean difference -2.37 kg, 95% confidence interval -3.45 to -1.30), lorcaserin (mean difference -2.36 kg, 95% confidence interval -4.58 to -0.15), respectively, had the most effect on weight loss compared with the placebo group. In addition, orlistat compared to lorcaserin (mean difference -0.01 kg, 95% confidence interval -2.47 to 2.45) resulted in more weight loss, but compared to metformin (mean difference 2.07 kg, 95% confidence interval -2.78 to 7.02) and sibutramine (mean difference 0.52 kg, 95% confidence interval -4.46 to 5.50) lead to less weight loss.
Conclusion: The present study indicated that orlistat had a greater effect on weight loss compared with lorcaserin, and had lower effect on weight loss compared with sibutramine and metformin in apparently healthy obese individuals.

Background: Diffusion-weighted imaging (DWI) is one of methods in evaluation of breast lesions. We aimed to investigate the apparent diffusion coefficient (ADC) values in breast tumors and their accuracy in differentiating benign versus malignant lesions.
Methods: In this cross-sectional study, 72 patients with 88 breast lesions were investigated by 1.5-T breast MRI from 2015 to 2017 in Athari Imaging Center in Tehran, Iran. Nearly all patients has undergone histopathology evaluation. One small region of interest (ROI) were placed on the most restricted region inside the solid part on the ADC map. Care was taken to avoid cystic or necrotic, fatty regions and hematoma inside the mass. A large round ROIs were placed in healthy fibroglandular tissue of contralateral breast ADC values were measured and compared in normal breast tissue and in most restricted parts of breast lesions (mass and non-mass). After determining cut-off for differentiation of benign and malignant lesions, sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.
Results: Mean age of patients was 43.3 years. The average tumor size of benign and malignant lesions were calculated 26.0 mm, 35.3 mm respectively and 23 mm and 46 mm in mass and non-mass respectively. Invasive ductal carcinoma include the majority of pathology result (in 37.5% of the patients). Our results revealed that the measured ADC values in normal breast tissue were higher than breast lesions (P≤0.01). Mean ADC value in benign lesions was 1.40×10-3 mm²/s and for malignant lesion was 1.08×10-3 mm²/s. ADC value in the normal breast tissue was 1.79×10-3 mm2/s and was significantly higher than ADC value of breast lesions (benign and malignant). Cut-off value in non-mass was not valid, but in mass was 1.19×10-3 mm²/s with sensitivity, specificity, positive predictive value, negative predictive and accuracy of 89.7%, 83.8%, 87.5%, 86.6%, and 87.1% respectively.
Conclusion: In DWI imaging, ADC value can differentiate benign and malignant masses with high sensitivity and specificity but not helpful in non-mass lesions.

Background: With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit.
Methods: The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups.
Results: There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly.
Conclusion: The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support.

Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy, which is associated with many serious consequences for mother and her fetus. Body mass index (BMI) in pregnant women is considered as one of most effective factor for the incidence of GDM. The aim of this study was to determine the relationship between BMI at pregnant women in the early months of pregnancy and the incidence of GDM.
Methods: In this retrospective cohort study, the case of six hundred fifty-nine pregnant women who referred to health centers in Kermanshah City from September 2010 to September 2012 by convenience sampling method were selected and investigated. This study was sponsored by Kermanshah University of Medical Sciences. Height and weight were measured for each woman at the beginning of pregnancy and maternal body mass index (BMI) was calculated based on height and weight measurements. Then the pregnant women were divided into four groups based on BMI: thin (BMI less than 18.9 kg/m2), normal (BMI between 19 kg/m2 and 24.9 kg/m2), overweight (BMI between 25 kg/m2 and 29.9 kg/m2) and obese (BMI more than 30 kg/m2). Those women who had diabetes at the beginning of pregnancy were excluded from the study. GDM was considered as fasting blood glucose ≥92 between 26-30 weeks of gestation.
Results: The mean±SD age of pregnant women was 27.7±5.85 year and the mean of BMI was 24.4±4.0 kg/m2. The GDM was shown in 30.7% of women. Association between BMI and GDM were statistically significant (P<0.001). The risk of GDM onset was 1.24 times, for each unit increased in BMI, (P<0.001). The risk of GDM was significantly higher in overweight [OR=2.97, CI (2.01-4.39)] and obese [OR=16.89, CI (8.46-33.70)] women. Being underweight increased the risk of GDM onset up to 1.19 times, but not significant.
Conclusion: There is a significant relationship between maternal BMI in pregnant women at the beginning of pregnancy with GDM onset. Increased BMI is correlated with an increase in the incidence of GDM.

Background: Obesity is one of the causes of onset and exacerbation of rheumatoid arthritis. However, limited studies have examined the association between body composition and severity of disease. The aim of this study was to evaluate the association between severity of rheumatoid arthritis with various types of obesity and the comparison of anthropometric indices between patients with rheumatoid arthritis and healthy subjects.
Methods: This case-control study was conducted on 95 patients (48.8±10.4 years) with rheumatoid arthritis as a case group and 95 healthy people (46±9.3 years) as a control group carried in Golestan Hospital, Ahvaz, Iran, from April 2016 to February 2017. Weight, height, waist circumference (WC), hip circumference (HC) and body fat percentage (BFP) were measured. The anthropometric indices were calculated. The disease severity was calculated according to disease activity score 28 (DAS28).
Results: There was no significant difference between two groups regarding their gender ratio (1:1), age (P=0.16) and height (P=0.58). The weight, body mass index (BMI), body fat (BF), WC, HC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and other obesity indices include a body shape index (ABSI), body adiposity index (BAI), abdominal volume index (AVI), body surface area (BSA) and Conicity index (CI) in patients with rheumatoid arthritis are significantly higher than healthy subjects (P<0.05). No difference in fat free mass was observed between two groups. Waist to height ratio and BAI compared with other indicators had the highest correlation with the DAS28 score. In addition, prevalence of obesity by waist circumference (82% vs. 61%), obesity by BMI (47% vs. 33%), and obesity by BFP (91% vs. 83%) was higher in patients with rheumatoid arthritis than healthy subjects. The risk of rheumatoid arthritis in people with central obesity by waist circumference (OR=2.92, 95% CI 1.50-5.70) was greater than obesity defined by BMI (OR=1.77, 95% CI 0.98-3.18) or BFP (OR=2.37, 95% CI 1.01-5.53).
Conclusion: The results of present study indicate association of rheumatoid arthritis disease severity with obesity types (especially central obesity) and anthropometric indices.
 

Background: TRX training is a new training method that has beneficial effects on improving balance and strength. However, the role of these types of training on the factors associated with function and mitochondrial biogenesis is not understood. Therefore, the purpose of present study was to determine the effect of eight weeks of TRX training on serum levels of Peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) and citrate synthase in overweight women.
Methods: All subjects gave written informed consent after a detailed description of the study procedures. The protocol of this study was approved by the Research Ethics Committee of Sport Sciences Research Institute (SSRI) in Iran. The present study was experimental and was conducted in Shahid Ghaffari women's club in Tehran under the supervision of Alzahra University from May 2018 to January 2019. For this purpose, 30 overweight women after primary alignment on basis of body mass index (25-30 kg/m2) were divided into two groups: control (n=14) and TRX training (n=16). The TRX training protocol was performed for eight weeks and 3 sessions per week, which included 6 main movements (squat, rear deltoid row, biceps curl, chest press, low row, rotational ward) that lasted 60 minutes per session. According to consideration the physical condition of each person, the subjects were free to modulate the exercise intensity by changing the body inclinations. Each exercise provided 4 sets of 12 repetitions separated by one-minute rest. Blood sampling was performed in two stages of pre-test and 48 hours after the last session of the exercise in overnight fasting state. After collection of serum samples, enzyme-linked immunosorbent assay (ELISA) method was used to measure serum levels of PGC-1α and citrate synthase.
Results: The results showed that TRX training caused no significant change in the body weight and body mass index compared to the control group. In addition, TRX training increased significantly the serum levels of PGC-1α and citrate synthase compared to the pre-test and the control group.
Conclusion: The findings of the present study indicated that eight weeks of TRX training could increase serum levels of PGC-1α and citrate synthase in overweight women.

Background: Today, overweight and obesity are major health concerns in developed and developing countries. Meanwhile, the issue is particularly important in children due to its consequences in adulthood. This study aimed to investigate the frequency of overweight and obesity in preschool children in Kerman, Iran.
Methods: This cross-sectional survey was conducted from December to March of 2016 among 731 preschool children (5 to 6 years old) who were selected using convenience sampling. The nutritional status of children was assessed according to the World Health Organization (WHO) expert committee guideline and based on body mass index (BMI) curves for age for boys and girls. Data were analyzed by SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). Chi-square test was used for data analysis, and the significance level was considered less than 0.05.
Results: In this study, 376 boys (51.5%) and 355 girls (48.5%) were investigated. The mean and standard deviation of the age of the participants was 68.7±4.2 months, 53% of these children were first children of the family and 30% of them were only children. The prevalence of overweight and obesity was 9.2% and 8.1% respectively. There was no significant relationship between overweight and obesity with gender, number of siblings and parents' education. There was a borderline difference in birth order (P=0.05) and the frequency of overweight and obesity in the firstborn children was more than other birth orders.
Conclusion: The prevalence of overweight and obesity was high in preschool children. Since these risk factors in children are predictors of chronic diseases during adulthood, we need to design and implement interventions to decrease the prevalence of overweight and obesity in children.

Background: spacecrafts rotate around the Earth every 90 minutes, so the 24-hour cycle turns to 90 minutes. Retinoic acid, an active metabolite of vitamin A, plays a role in regulating the circadian rhythm and its deficiency can impair the biological clock function and consequently impair the circadian rhythm of locomotor activity. The goal of the study was to assay the effects of simulated spaceship conditions on serum and hippocampal retinoic acid levels in rats.
Methods: The tail-hanging, hindleg-weightlessness rat model was applied to mimic the microgravity conditions from June to September 2017 in the zoo of the Aja University of Medical Sciences. Thirty-two male Wistar rats weighing 200-250 gr/in an experimental study were randomly assigned into 4 groups (n=8): 1) control animals with 12/12 h day-night rotation, 2) animals with 12/12 h day-night rotation under 14 days unloading, 3) control animals with 45/45 min day-night cycle, and 4) animals with 45/45 min day-night cycle under 14 days unloading. At the termination of the simulation step, rats were anesthetized, and blood samples were collected and the entire brain was removed and each brain was segmented into Hippocampus. ELISA assays were used to detect retinoic acid in the serum and homogenized hippocampus. Data were statistically assayed using two-way ANOVA and Bonferroni as a post hoc test. P<0.05 was considered significant.

Background: one of the leading clinical problems for premature neonates especially with very low birth weight is the type and amount of feeding. The authors aimed to compare outcomes of slow versus rapid feeding in premature neonates hospitalized in Al-Zahra hospital, Rasht.
Methods: This is a clinical trial that was conducted on 62 premature neonates aged less than 35 weeks of gestation who were referred to Al-Zahra Hospital from April 2015 to April 2016. They weighed 1000-2000 gr at birth. Samples were randomly assigned to intervention or control groups. The intervention included neonatal feeding with breast milk or formula with feeding advancement of 30 cc/kg/day which was compared with the routine method of slow feeding (20 cc/kg/day). Neonates were assessed until discharge or the occurrence of Necrotizing enterocolitis. Data were reported by descriptive statistics including mean, standard deviation, frequency, and percent, and analyzed by independent samples t-test and chi-square test in SPSS software, version 22 (IBM SPSS, Armonk, NY, USA).

Background: The vertical gastric plication technique leads to poor long-term outcomes and is associated with intolerable reflux, dysphagia, or weight gain in a high percentage of patients. Therefore, in this study, the therapeutic results of two methods with and without plication of the distal part of the stomach in gastric bypass surgery in patients with morbid obesity were compared.
Methods: In this clinical trial randomized single-blind study, 40 patients with morbid obesity who were referred to one of the hospitals affiliated with Jundishapur University of Medical Sciences in Ahvaz during March 2020-February 2021, were randomly divided into two groups: with plication of the distal part of the stomach (n=20) and without plication of the distal part of the stomach (n=20) in Roux-en-Y gastric bypass surgery. Weight loss rate, complications related to surgery, outcomes and satisfaction of patient were noted and followed up for one year.
Results: The mean percentage of weight loss at different times did not show a significant difference between the two groups (p>0.05). The length of hospitalization after surgery was significantly less in the distal gastric plication group (p=0.0001). During one year of follow-up, hypertension, diabetes, HLP, and reflux were well in the distal plication method but showed no significant difference (p>0.05). Satisfaction of the patients was more in the distal plication method and showed no significant difference (p>0.05). One year after the operation, the change of diet showed no significant difference in the two groups (p>0.05).
Conclusion: It looks that using the laparoscopic distal gastric plication method is an effective and safe method and is associated with early ideal weight loss, reduction of complications, and increase in satisfaction of patients with BMI>=35 kg/m2. No need to use a foreign body, stapler or bandage and the possibility of re-operation are the advantages of this technique.

Background: Obesity and overweight are one of the components of metabolic syndrome and the cause of cardiovascular disease and sudden cardiac death. Obesity is associated with a wide range of electrocardiogram (ECG) abnormalities.
Methods: This case-control study was performed on 50 children and adolescents aged 9 to 18 years in Birjand from May to October 2020. In the control group, 25 people with normal weight and in the case group, 25 people with obesity or overweight were included in the study. Individuals with a body mass index of 85-95 percent were defined as overweight, ones with a body mass index above the 95th percentile were defined as obese, and individuals with a body mass index below the 85th percentile were defined as normal. After clinical examination, height, weight and electrocardiogram indices were measured and compared by using statistical tests by SPSS (Version 19) software.

Results: There were 15 boys in the control group and 17 boys in the case group. The mean age of the control and case groups was 11.28±2.13 and 10.96±1.97 years, respectively. The mean distance between the peak to the end of the T wave in the case group was 323.72±120.15 and in the control group was 79.20±13.06. The mean difference between the shortest and longest distance of TP-e in case group was 48±23.04 and in control group was 18.44±5.58, respectively. There was a statistically significant difference between the two indices (P<0.001). But in other variables, no statistically significant difference was observed between the two groups.

Background: Prostate cancer (PCa) has been one of the most prevalent cancers in men in recent years. Multi-parametric magnetic resonance imaging (mp-MRI) has been increasingly applied in the diagnosis, localization and staging of prostate cancer. This approach uses a combination of morphology information obtained from T2-weighted image along with at least two functional imaging modalities, such as diffusion-weighted (DWI), dynamic-contrast-enhancement (DCE), and magnetic-resonance-spectroscopy (MRS). This review gives a comprehensive overview of the theories and methodologies of the mp-MRI for diagnosing prostate cancer. The search was fulfilled using a list of search engines.
Methods: In this study, with a systematic review of studies conducted during February 2015 to October 2021, the role and potential of integrating the results of morphological and functional imaging in a multi-parameter approach were evaluated and the optimal combination was introduced. This article collected studies that have employed mp-MRI in prostate cancer including: peer-reviews, research articles, academic reports and conferences. This review has been studied from September 2016 to January 2022.

Results: According to the reported results, the optimum combination of T2-w, DWI and DCE in the mp-MRI approach provides the highest sensitivity and specificity in the diagnosis, localization and staging of prostate cancer. Applying the field strength of 3T versus 1.5T improves detection accuracy including improving sensitivity and specificity as well, and also the application of endorectal coils does not provide much advantage compared to pelvic phased-array coil in term of prostate cancer detection accuracy.  Conclusion: MP-MRI as a precision instrument plays a valuable role in the diagnosis of prostate cancer. The most suitable combination of the pulse sequences to achieve the goals of this approach is T2-w, DWI and DCE. This review is comprehensive overview covered previous articles of mp-MRI in prostate cancer for all the researchers in this field and expresses the positive and negative points of each modality. Moreover, this article reports the sensitivity and the Specificity of the recent researches.

Background: birth weight is associated with neonatal mortality and morbidity .In recent studies, fetal growth is related to the risk of developing type two diabetes and cardiovascular disease in later life. The mother’s nutrition and metabolism are major determinants of fetal growth. Some complications of low birth weight are hypocalcemia, hypoglycemia, intrauterine death. Any substance or hormone that can cross the placenta may affect the fetal growth and birth weight, including the maternal lipid during pregnancy. The effect of gestational diabetes mellitus on neonatal birth weight has been documented. Lipids and amino acids usually are not considered in the clinical management of pregnancy because there is less known about the role of these nutrients in the well-being of the pregnancy. This study aimed to determine the relationship between levels of serum lipids in pregnancy and fetal birth weight.
Methods: This descriptive cross-sectional study was performed on 170 pregnant women referred to Kerman medical university clinics in Iran from March 2019 to April 2020. After explaining the objectives of the study and gaining informed consent from the individuals, the maternal lipid profile during the first trimester of pregnancy, was measured within the first visit through a sample taken from the maternal blood. Pregnant women were monitored during pregnancy, and the variables were measured (Age, BMI, weight, frequency of pregnancy, weight gain in pregnancy, lipid and blood glucose profiles). The results of the samples were analyzed using SPSS software, version 20 (IBM SPSS, Armonk, NY, USA).
Results: The results indicated that the newborn weight increases with an increment in the maternal blood cholesterol (P=0.001) and triglyceride (P=0.001) levels. In addition, it was found that the increasing HDL (P=0.867) and LDL (P=0.803) levels of the pregnant women’s blood, does not lead to the birth weight increase of the infants.

Conclusion: Results of our study generally indicate that triglyceride and cholesterol levels are related to fetal birth weight. Studies with high sample sizes are recommended to investigate all neonatal weight gain variables.

Managing overweight and obesity is associated with lower risks of chronic diseases like diabetes. Digital health, particularly smartphones or m-health, effectively manages body weight. Technologies such as telemedicine services, mobile health (mHealth) or the use of mobile phones or portable digital devices in healthcare services and wearable devices can be used in this field. Therefore, this study was conducted to understand the impact of digital health technologies on weight management in diabetic patients.
Methods: The present study is a systematic review study that was initially searched using a systematic review of published studies in the field of digital health for weight management in diabetic patients from October 1401 to October 1402. Our study was conducted in two rigorous steps. Firstly, we performed a systematic review by searching for publications on Digital Health Solutions for Body Weight Management in Diabetic Patients until 12 October 2022. We meticulously combed through two comprehensive databases, PubMed and Web of Science, using a set of specific and relevant keywords. After a thorough screening and full-text assessment, we handpicked eight documents for this study. We cross-referenced with the companies' websites producing the identified applications to enrich our findings further.

Results: In the initial search, 223 documents were identified and after screening and qualitative evaluation, eight documents were selected for this study. Our research uncovered a range of mHealth apps that have shown promise in weight management for diabetic patients. These apps have demonstrated potential efficacy, high acceptability, and favorable user experiences. Importantly, they have also improved diabetes management and quality of life for the users. Conclusion: Our review of digital health solutions has not only illuminated their potential in weight management for diabetic patients but also opened up new avenues for a more personalized, engaging, and practical approach to this issue. As technology continues to advance, these interventions hold the potential to revolutionize diabetes self-management, significantly enhance the quality of life, and contribute to better health outcomes for individuals living with diabetes.

Conclusion: High body mass index of the mother and weight gain during pregnancy can cause complications in the mother and the fetus. Therefore, prenatal care should be done more carefully and health care providers should place mothers who have abnormal body mass index and inappropriate weight gain in pregnancy in the high-risk group and under special care to minimize maternal and fetal complications.

Background: Gallstones are a common gastrointestinal complication following bariatric surgery, potentially resulting in cholecystitis, cholangitis, and pancreatitis. These complications arise due to biliary homeostasis alterations and rapid postoperative weight loss. Ursodeoxycholic acid (UDCA) has been shown to reduce biliary cholesterol saturation, thereby preventing gallstone formation. This study aimed to evaluate the effectiveness of Ursobil (UDCA) in preventing gallstones in patients undergoing bariatric surgery.
Methods: This case-control study was conducted study was conducted at Golestan Hospital in Ahvaz, Iran, from October 2022 to March 2023. Ethical approval was obtained from the institutional review board. Patients aged 18 to 65 years with a BMI between 35 and 65 kg/m² were eligible. Exclusion criteria included a history of gallstones, previous bariatric or cholecystectomy surgery, inflammatory bowel disease, recent UDCA use, or bleeding disorders. Participants were divided into two groups: the case group received 600 mg of UDCA daily for six months postoperatively, while the control group received no UDCA. Abdominal ultrasonography was performed before surgery and six months afterward. Outcome measures included gallstone formation, weight loss, need for cholecystectomy, and health-related quality of life, assessed using the WHOQOL-BREF questionnaire.
Results: The two groups were comparable in terms of age, gender distribution, and baseline BMI. The mean weight loss was similar between groups after six months. Gallstone formation occurred in 1.7% (n=1) of the UDCA group compared to 15% (n=9) of the control group (P=0.012). None of the patients in the intervention group required cholecystectomy, whereas 11.7% (n=7) in the control group underwent the procedure (P=0.011). Quality of life scores were higher in the UDCA group, though not statistically significant.
Conclusion: Oral administration of UDCA effectively and significantly reduces the risk of gallstone formation and the need for cholecystectomy in post-bariatric surgery patients. Routine use of UDCA during rapid weight loss phases may improve clinical outcomes and reduce gallstone-related complications. Preventive use of UDCA may effectively and significantly reduce gallstone-related morbidity in patients undergoing rapid weight loss.
 

Background: In this study, Botox method is compared with sleeve gastrectomy as one of the endoscopic methods in the treatment of obesity for patients who are not effective in lifestyle and drug modification methods and do not have the interest or necessary conditions for bariatric surgery.
Methods: This Cross-sectional study was conducted in eligible patients who were outpatients at the gastroenterology clinics of Amir al-Momenin Hospital, Arak, in June 2014 for one year in the gastroenterology clinic after obtaining informed consent, demographic information, and anthropometric measurements. After 12 weeks, patients in both groups were visited again. In patients in group A (Botox group), endoscopy was performed by an experienced gastroenterologist under sedation after a 10-hour fast, and in patients in group B (sleeve gastrectomy) under general anesthesia, a partial and longitudinal gastrectomy was performed. The BAROS questionnaire was used to assess the quality of life of patients.
Results: The mean age of the subjects in the endoscopic botulinum neurotoxin group was 30.88±11.89 years and the sleeve gastrectomy group was 29.88±11.06 years. In this study, 12 subjects (24.0%) were male and 38 subjects (76%) were female. There was a significant difference in the mean body mass index and weight at four measurements in the two study groups (endoscopic botulinum neurotoxin and sleeve gastrectomy). There was no statistically significant difference in the mean blood pressure, laboratory results, and mean quality of life in the study groups.
Conclusion: Endoscopic botulinum injection in the stomach is an effective and safe method for short-term weight loss, but its long-term effect on weight and the occurrence of complications or metabolic effects requires long-term follow-up.